Forming implementation intentions has been consistently shown to be a powerful self-regulatory strategy. As the self-regulation of thoughts is important for the experience of involuntariness in the hypnotic context, investigating the effectiveness of implementation intentions on the suppression of thoughts was the focus of the present study. Participants were randomly assigned to one of four conditions (hypnotic instruction plus implementation intention, hypnotic instruction, implementation intention, and control condition). Results showed that participants who received information included in the "Carleton Skill Training Program" and in addition formed implementation intentions improved their hypnotic responsiveness as compared to all of the other three groups on measures of objective responding and involuntary responding. Thus, in line with the nonstate or cognitive social-psychological view of hypnosis stating that an individual's hypnotic suggestibility is not dispositional but modifiable, our results suggest that hypnotic responsiveness can be heightened by furnishing hypnotic instructions with ad hoc implementation intentions.

Conscious Cogn. 2012 Jun;21(2):1023-30. Schweiger Gallo I, Pfau F, Gollwitzer PM. Departamento de Psicología Social, Facultad de Ciencias Políticas y Sociología, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Madrid, Spain.

INTRODUCTION: After a hypnotic induction, medium and highly hypnotizable individuals often report spontaneous alterations in various dimensions of consciousness. Few studies investigating these experiences have controlled for the inherent demands of specific hypnotic suggestions and fewer still have considered their dynamic properties and neural correlates. METHODS: We adopted a neurophenomenological approach to investigate neutral hypnosis, which involves no specific suggestion other than to go into hypnosis, with 37 individuals of high, medium, and low hypnotizability (Highs, Mediums, and Lows). Their reports of depth and spontaneous experience at baseline, following a hypnotic induction, and then after multiple rest periods were analyzed and related to EEG frequency band power and global functional connectivity. RESULTS: Hypnotizability was marginally associated with lower global functional connectivity during hypnosis. Perceived hypnotic depth increased substantially after the induction especially among Highs and then Mediums, but remained almost unchanged among Lows. In the sample as a whole, depth correlated moderately to strongly with power and/or power heterogeneity for the fast EEG frequencies of beta2, beta3, and gamma, but independently only among Highs. The spontaneous phenomenology of Lows referred primarily to the ongoing experiment and everyday concerns, those of Mediums to vestibular and other bodily experiences, and those of Highs to imagery and positive affect/exceptional experiences. The latter two phenomena were associated with lower global functional connectivity during hypnosis. Imagery correlated positively with gamma power heterogeneity and negatively with alpha1 power heterogeneity. Generally, the pattern of correlations for the Highs was the opposite of that for the Lows. CONCLUSIONS: Experienced hypnotic depth and spontaneous phenomena following a neutral hypnotic induction vary as a function of hypnotizability and are related to global functional connectivity and EEG band wave activity.

Cortex. 2012 Apr 11 Cardeña E, Jönsson P, Terhune DB, Marcusson-Clavertz D. Center for Research on Consciousness and Anomalous Psychology (CERCAP), Department of Psychology, Lund University, Sweden.

This article describes cognitive hypnotherapy (CH), a visionary model of adjunctive hypnotherapy that advances the role of clinical hypnosis to a recognized integrative model of psychotherapy. As hypnosis lacks a coherent theory of psychotherapy and behavior change, hypnotherapy has embodied a mixed bag of techniques and thus hindered from transfiguring into a mainstream school of psychotherapy. One way of promoting the therapeutic standing of hypnotherapy as an adjunctive therapy is to systematically integrate it with a well-established psychotherapy. By blending hypnotherapy with cognitive behavior therapy, CH offers a unified version of clinical practice that fits the assimilative model of integrated psychotherapy, which represents the best integrative psychotherapy approach for merging both theory and empirical findings.

Am J Clin Hypn. 2012 Apr;54(4):249-62. Alladin A. University of Calgary, Calgary, Alberta, Canada. Assen.Alladin@albertahealthservices.ca

Hypnosis has long been known to be associated with heightened control over physical processes and researchers put it under consideration because of its usage as a therapeutic tool in many medical and psychological problems. Determination of hypnosis susceptibility level is important before prescribing any hypnotic treatment. In this study different features are introduced to classify hypnotizability levels. These features were extracted from electroencephalogram (EEG) signals which were recorded from 32 subjects during hypnosis suggestion. Based on the obtained result, a method was suggested to estimate the hypnosis susceptibility level from hypnosis EEG signals instead of using traditional clinical subjective tests.

Comput Biol Med. 2012 May;42(5):590-7. doi: 10.1016/j.compbiomed.2012.02.003. Baghdadi G, Nasrabadi AM. Biomedical Engineering Department, Shahed University, Across Emam Khomeini Holy Shrine, Persian Gulf Highway, Tehran, Iran. golnaz_baghdadi@yahoo.com

The purpose of our study was to measure the relationship between performance on various attentional tasks and hypnotic susceptibility. Healthy volunteers (N=116) participated in a study, where they had to perform several tasks measuring various attention components in a waking state: sustained attention, selective or focused attention, divided attention and executive attention in task switching. Hypnotic susceptibility was measured in a separate setting by the Waterloo-Stanford Groups Scale of Hypnotic Susceptibility, Form C (WSGC). We found no significant correlation between any of the attentional measures and hypnotic susceptibility. Highly hypnotizables did not prove to be superior to or worse than the other individuals in any of the tests. These results do not support the neuropsychophysiological model of hypnosis, as they show no consistent relationship between hypnotic susceptibility and waking attentional performance.

Copyright © 2011 Elsevier Inc. All rights reserved.

Conscious Cogn. 2011 Dec;20(4):1872-81. Epub 2011 Oct 2. Varga K, Németh Z, Szekely A. Institute of Psychology, Eötvös Loránd University, Izabella utca 46. Pf. 755, Budapest H-1384, Hungary. varga.katalin@ppk.elte.hu

BACKGROUND: The Cerebral State Monitor™ (CSM) is an electroencephalogram (EEG)-based monitor that is claimed to measure the depth of hypnosis during general anesthesia. We calculated the prediction probability (P(K)) for its ability to separate consciousness from unconsciousness in surgical patients with different anesthetic regimens. METHODS: Digitized EEG recordings of a previous study of 40 nonpremedicated, adult patients undergoing elective surgery under general anesthesia were replayed using an EEG player and reanalyzed using the CSM. Patients were randomly assigned to receive either sevoflurane-remifentanil or propofol-remifentanil. The study design included a slow induction of anesthesia and an episode of intended wakefulness. CSM values at loss and return of consciousness were compared. P(K) was calculated from values 30 seconds before and 30 seconds after loss and return of consciousness. RESULTS: The P(K) for the differentiation between consciousness and unconsciousness was 0.75 ± 0.03 (mean ± SE). For sevoflurane-remifentanil, P(K) was 0.71 ± 0.04. For propofol-remifentanil, P(K) was 0.81 ± 0.03. CONCLUSIONS: The ability of CSM for separation of consciousness and unconsciousness was comparable to other commercially available EEG-based indices.

Anesth Analg. 2011 Dec;113(6):1403-10. Pilge S, Blum J, Kochs EF, Schöniger SA, Kreuzer M, Schneider G. Department of Anesthesiology I, Helios Klinikum Wuppertal, University Witten/Herdecke, Heusnerstr. 40, 42283 Wuppertal, Germany.

Hypnosis has had a long and controversial history in psychology, psychiatry and neurology, but the basic nature of hypnotic phenomena still remains unclear. Different theoretical approaches disagree as to whether or not hypnosis may involve an altered mental state. So far, a hypnotic state has never been convincingly demonstrated, if the criteria for the state are that it involves some objectively measurable and replicable behavioural or physiological phenomena that cannot be faked or simulated by non-hypnotized control subjects. We present a detailed case study of a highly hypnotizable subject who reliably shows a range of changes in both automatic and volitional eye movements when given a hypnotic induction. These changes correspond well with the phenomenon referred to as the trance stare" in the hypnosis literature. Our results show that this 'trance stare' is associated with large and objective changes in the optokinetic reflex, the pupillary reflex and programming a saccade to a single target. Control subjects could not imitate these changes voluntarily. For the majority of people, hypnotic induction brings about states resembling normal focused attention or mental imagery. Our data nevertheless highlight that in some cases hypnosis may involve a special state, which qualitatively differs from the normal state of consciousness.

PLoS One. 2011;6(10):e26374. Kallio S, Hyönä J, Revonsuo A, Sikka P, Nummenmaa L. School of Humanities and Informatics, University of Skövde, Skövde, Sweden. sakari.kallio@his.se

Full title: The use of Complementary and Alternative Medicine in pregnancy: data from the Avon Longitudinal Study of Parents and Children (ALSPAC).

OBJECTIVES: To report the frequency of Complementary and Alternative Medicine (CAM) use by a population of pregnant women in the UK. DESIGN: Four postal self-completion questionnaires completed at 8, 12, 18 and 32 weeks' gestation provided the source of CAMs used. Questions asked for written descriptions about the use of any treatments, pills, medicines, ointments, homeopathic medicines, herbal medicines, supplements, drinks and herbal teas. SETTING: An observational, population-based, cohort study of parents and children of 14,541 pregnant women residing within the former county of Avon in south-west England. Data was available for 14,115 women. RESULTS: Over a quarter (26.7%; n=3774) of women had used a CAM at least once in pregnancy, the use rising from 6% in the 1st trimester to 12.4% in the 2nd to 26.3% in the 3rd. Herbal teas were the most commonly reported CAM at any time in pregnancy (17.7%; n=2499) followed by homeopathic medicine (14.4%; n=2038) and then herbal medicine (5.8%; n=813). The most commonly used herbal product was chamomile used by 14.6% of women, the most commonly used homeopathic product was Arnica used by 3.1% of women. Other CAMs (osteopathy, aromatherapy, acupuncture/acupressure, Chinese herbal medicine, chiropractic, cranial sacral therapy, hypnosis, non-specific massage and reflexology) accounted for less than 1% of users. CONCLUSIONS: CAM use in pregnancy, where a wide range of CAMs has been assessed, has not been widely reported. Studies that have been conducted report varying results to this study (26.7%) by between 13.3% and 87% of pregnant women. Survey results will be affected by a number of factors namely the inclusion/exclusion of vitamins and minerals, the timing of data collection, the country of source, the number of women surveyed, and the different selection criteria of either recruiting women to the study or of categorising and identifying a CAM treatment or product.

Copyright © 2011 Elsevier Ltd. All rights reserved.

Complement Ther Med. 2011 Dec;19(6):303-10. doi: 10.1016/j.ctim.2011.08.005. Epub 2011 Sep 14. Bishop JL, Northstone K, Green JR, Thompson EA. University of Bristol, School of Social & Community Medicine, Barley House, Oakfield Grove, Bristol, UK. jackie.bishop@bristol.ac.uk

Full title: Hypnosis: a twilight zone of the top-down variety Few have never heard of hypnosis but most know little about the potential of this mind-body regulation technique for advancing science.

An early form of psychotherapy, hypnosis has been tarnished by a checkered history: stage shows, movies and cartoons that perpetuate specious myths; and individuals who unabashedly write 'hypnotist' on their business cards. Hypnosis is in the twilight zone alongside a few other mind-body exemplars. Although scientists are still unraveling how hypnosis works, little is mystical about this powerful top-down process, which is an important tool in the armamentarium of the cognitive scientist seeking to unlock topical conundrums.

Copyright © 2011 Elsevier Ltd. All rights reserved.

Trends Cogn Sci. 2011 Dec;15(12):555-7. Raz A. Institute for Community and Family Psychiatry, Jewish General Hospital, Montreal, Quebec H3T 1E4, Canada. amir.raz@mcgill.ca

Erotomania is the delusional belief that one is loved from afar by another person (the target). This study used hypnosis as a novel cognitive neuropsychological research tool to model erotomania. The authors developed 2 versions of a hypnotic erotomania suggestion and tested their impact by asking subjects to recall and interpret a story featuring ambiguous scenarios. They also challenged the delusion by asking subjects to justify their beliefs. The hypnotic erotomania suggestions successfully recreated the features of the clinical delusion for many high hypnotizable subjects. They believed that the target loved them, interpreted ambiguous information consistent with this belief and confabulated evidence in service of their delusion. Some also resisted all challenges to their delusion. These features are strikingly similar to clinical cases and highlight the value of using hypnosis to model clinical delusions. The authors also discuss some limitations of this approach.

Int J Clin Exp Hypn. 2012;60(1):1-30. Attewell JE, Cox RE, Barnier AJ, Langdon R. Macquarie University, Sydney, Australia.

This study (N = 37 with high, medium, and low hypnotizables) evaluated depth reports and EEG activity during both voluntary and hypnotically induced left-arm lifting with sLORETA functional neuroimaging. The hypnotic condition was associated with higher activity in fast EEG frequencies in anterior regions and slow EEG frequencies in central-parietal regions, all left-sided. The voluntary condition was associated with fast frequency activity in right-hemisphere central-parietal regions and slow frequency activity in left anterior regions. Hypnotizability did not have a significant effect on EEG activity, but hypnotic depth correlated with left hemisphere increased anterior slow EEG and decreased central fast EEG activity. Hypnosis had a minimal effect on depth reports among lows, a moderate one among mediums, and a large one among highs. Because only left-arm data were available, the full role of the hemispheres remains to be clarified.

Int J Clin Exp Hypn. 2012;60(1):31-53. Cardeña E, Lehmann D, Faber PL, Jönsson P, Milz P, Pascual-Marqui RD, Kochi K. Department of Psychology, Lund University, Lund, Sweden. Etzel.Cardena@psychology.lu.se

Cerebral blood flow was measured in normal waking (alert relaxed mental imagery) and hypnotic states. Mean flow velocity (Vm) in the middle cerebral artery (MCA) was significantly increased in hypnosis (Condition II) from Condition I (5 minutes before hypnotic induction). Vm decreased in Condition III (hypnotic imagination). After hypnosis, Vm values returned to baseline. Pulsatility index values and resistive index values showed significant variations during sonographic monitoring between Conditions I and IV (5 minutes after the completion of hypnosis). Both values were significantly higher in Condition I than IV. These findings show that hypnotic status can modulate cerebral blood flow.

Int J Clin Exp Hypn. 2012;60(1):81-7. Uslu T, Ilhan A, Ozcan O, Turkoglu D, Ersoy A, Celik E. Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

Full title: Electromyographic investigation of hypnotic arm levitation: differences between voluntary arm elevation and involuntary arm levitation.

Thirty-three volunteers were randomly exposed to 3 conditions: hypnotic arm levitation, holding up the arm voluntarily without hypnosis, and imagined arm lifting without hypnosis. Trapezius, deltoid, extensor digitorum, flexor digitorum profundus, biceps brachii, and triceps brachii muscles were measured. Strain and muscle activity during lifting and holding up the right arm for 3 minutes were used as dependent variables. During hypnotic arm levitation, the total muscle activity was lower than during holding it up voluntarily (p < .01); the activity in the deltoid was 27% lower (p < .001). Without hypnosis, the muscle activity showed a positive correlation with strain. However, there was no such correlation in the hypnotic condition. Apparently, it is possible to reduce strain and to objectively measure muscle activity in an uplifted arm through hypnotic arm levitation.

Int J Clin Exp Hypn. 2012;60(1):88-110. Peter B, Schiebler P, Piesbergen C, Hagl M. Ludwig Maximilians University of Munich, Germany. Burkhard-Peter@t-online.de

This functional Magnetic Resonance Imaging (fMRI) study investigated high and low suggestible people responding to two visual hallucination suggestions with and without a hypnotic induction. Participants in the study were asked to see color while looking at a grey image, and to see shades of grey while looking at a color image. High suggestible participants reported successful alterations in color perception in both tasks, both in and out of hypnosis, and showed a small benefit if hypnosis was induced. Low suggestible people could not perform the tasks successfully with or without the hypnotic induction. The fMRI results supported the self report data, and changes in brain activity were found in a number of visual areas. The results indicate that a hypnotic induction, although having the potential to enhance the ability of high suggestible people, is not necessary for the effective alteration of color perception by suggestion.

Copyright © 2011 Elsevier Inc. All rights reserved.

Conscious Cogn. 2011 Nov 26. McGeown WJ, Venneri A, Kirsch I, Nocetti L, Roberts K, Foan L, Mazzoni G. Department of Psychology, University of Hull, UK.

by Tim Brunson PhD

There is a superhero obsession in Eastern and Western culture. Just look at the Hollywood box office hits for the past several years. Titles like Spiderman, Batman Returns, Daredevil, X-Men and even the Harry Potter series are just a handful of an army of such movies. Add to this a steady fare of similar fictional stories that find there way into our homes via our cable television provider. Yes, even hit series like Heroes and 4400 continue satisfying our craving for stories about magical human potential. Other than importing these movies and shows to their theaters, our Eastern cousins have always had their martial arts heroes, which they have often exported back to us in the forms of Bruce Lee, Jet Li and Jackie Chan.

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The authors present empirical data on therapeutic hypnosis and brief psychotherapy as a 4-Stage Creative Process of focused attention and positive expectancy in professional training workshops of the American Society of Clinical Hypnosis, the National Institute for the Clinical Applications of Behavioral Medicine, and the Milton H. Erickson Foundation. The authors developed a brief protocol for assessing the 4-Stage Creative Process, which is the core dynamic of the Creative Psychosocial Genomic Healing Experience. They report that the 4-Stage Creative Process for resolving many psychological problems and symptomatic behavior in a satisfactory manner can be learned within 3 trials during 2-day professional workshops. The theory, research, and practice of private problem solving, stress reduction, and mind-body symptom resolution in professional and public settings is discussed. Immediate knowledge of results, positive peer support, and the development of new psychosocial skills in learning how to appropriately communicate live here-and-now novel and numinous experiences is an exhilarating exercise in creating new consciousness that facilitates the confidence and maturation of psychotherapists.

Am J Clin Hypn. 2011 Oct;54(2):133-52. Rossi EL, Cozzolino M, Mortimer J, Atkinson D, Rossi KL. Milton H. Erickson Institute of the California Central Coast, Los Osos, California, USA. Ernest@ErnestRossi.com

by Tim Brunson PhD

This whole issue of gene expression is a very fascinating hypothesis. Although I completed a course with Rossi a couple of years ago and attended a course by another psychologist around the same time, I don't see the idea catching on with other researchers.

A lot of Rossi's ideas on this subject concern altering gene expression based upon environmental inputs. Indeed, stress would be an example of such an input. A stressful situation would result in the generation (or production) of "stress proteins." Such stress proteins can interfere with optimal performance and ultimately produce psychosomatic illnesses.

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Full title: Cholinergic anti-inflammatory pathway of some non-pharmacological therapies of complementary medicine: possible implications for treatment of rheumatic and autoimmune diseases.

Rheumatologic and autoimmune diseases are among foremost diseases for which patients seek complementary and integrative medicine options. Therefore, physicians should be informed on the advances in research of these therapies, in order to be able to discuss possible indications and contraindications for these treatment modalities with their patients. This review summarizes several therapeutic modalities of complementary medicine that may be involved in the cholinergic anti-inflammatory pathway. The analysis of systematic reviews of acupuncture for rheumatic conditions has concluded that the evidence is sufficiently sound to warrant positive recommendations of this therapy for osteoarthritis, low back pain and lateral elbow pain. There is relatively strong evidence to support the use of hypnosis in pain treatment, such as in cases of fibromyalgia. A recent controlled study that evaLuated tai-chi in fibromyalgia has reported reductions in pain, improvements in mood, quality of Life, self efficacy and exercise capacity. There is also cumulative evidence that acupuncture, hypnosis and tai-chi may decrease the high frequency of heart rate variability, suggesting enhancement of vagus nerve activity. Hence, it has been hypothesized that these modalities might impact the cholinergic anti-inflammatory pathway to modulate inflammation. Further clinical and basic research to confirm this hypothesis should be performed in order to validate integration of these therapies in comprehensive treatment for some inflammatory and autoimmune diseases.

Harefuah. 2011 Aug;150(8):660-3, 687. Gamus D. Complementary Medicine Service, Sheba Medical Center, Tel-Hashomer. dorit.gamus@sheba.health.gov.il

Obtaining complete information lies at the heart of accurate diagnosis in all healthcare fields. Extracting information is a time-honored purpose of the history and physical examination. Practitioners may not be aware that these functions also provide opportunities to impart positive verbal and nonverbal suggestions. Paying attention to language promotes patient self-mastery and helps forge a therapeutic alliance for successful outcomes. Principles taught in hypnosis workshops can also help the practitioner avoid negative, undermining suggestions that could diminish diagnostic and therapeutic effectiveness.

Am J Clin Hypn. 2011 Jul;54(1):5-15. Berberich FR. Pediatric Suggestions, Berkeley, CA 94707, USA. dr.berberich@pediatricsuggestions.net

The popularity of complementary medicine in the western world continues to grow. Complementary medicine has a wide scope of topics including acupuncture, hypnosis, meditation, chiropractic manipulation, tai chi, yoga, botanical and herbal supplements and many other undefined modalities such as copper bracelets, magnets, holy water etc. For most modalities the mechanism of action is unknown and the evidence of benefit is poor. Some modalities such as acupuncture, hypnosis and tai chi may improve pain and other subjective complains. It seems that most of the beneficial effects of complementary medicine are placebo effects. Complementary treatment may be associated with side effects and should not be an alternative to the conventional medicine. Complementary medicine can be used as an adjunct to the conventional medicine and should be used in full agreement with and under the supervision of the attending physician. Patients should be informed about the existing evidence and what to expect from complementary medicine. Further meticulous research should be conducted to expand our knowledge in complementary medicine.

Harefuah. 2011 Aug;150(8):657-8, 687. Grossman E.

The role of parents in the use of hypnosis with their children raises many questions worthy of consideration. A survey of the literature reveals that this important topic has not been given the attention or depth it deserves. The author looks at (a) how, when, and whether to incorporate parents in the treatment of their children; (b) how to address attachment and trance between parent and child; (c) engaging parents in their own hypnotic abilities beginning as early as the birthing experience; and (d) improving parenting skills such as teaching parents to pay attention to their use of language with their children in order to shift patterns of communication from unproductive to useful. In addition, the author explores the ways to invite, teach, support and interact with the family system of parent and child in our hypnotic work.

Am J Clin Hypn. 2011 Jul;54(1):70-81. Linden JH. juliehlinden@comcast.net

Full Title: Complementary and alternative medicine (CAM) among hospitalised patients: Reported use of CAM and reasons for use, CAM preferred during hospitalisation, and the socio-demographic determinants of CAM users.

PURPOSE: This paper reports a study to examine hospitalised patients' frequency and patterns of CAM use, their reasons for CAM use, their preferences of CAMs during hospitalisation, and the association between patients' socio-demographic variables and use of each individual CAM/CAM domain. METHODS: A convenience sample of 353 patients hospitalised in 19 surgical wards at four metropolitan hospitals completed a questionnaire on CAM use and socio-demographic variables. RESULTS: The response rate was 73.5%, and over 90% of the sample acknowledged using CAMs. Non-herbal supplements (60.3%) and massage therapy (45%) were the most frequently used CAMs, with biologically based therapies (68.8%) as well as mind-body interventions (65.4%) being the most often used CAM domains. About 1 in 10 patients (9.6%) used CAMs from all five domains. With the exception of herbal-botanical therapies, self-prayer for health reasons/spiritual healing and music therapy, all CAMs were mainly used on an 'only when needed' basis. The most common reason nominated for using CAMs was that '[it] fits into my way of life/philosophy' (26%). The majority of patients declared interest in and support for the hospital providing CAMs. Patients were most inclined to choose therapies categorised as manipulative and body-based methods (65.4%) for use in hospital. Massage therapy (53.5%) and non-herbal supplements (43.1%) were the top two CAMs favoured for use in hospital. CAM use was also dependent of socio-demographic data (age, gender, marital status, place of residence, education level, religion, and income in hospitalised patients). CONCLUSION: The use of CAMs is pervasive amongst surgical in-patients, making it feasible to initially assess these patients for CAM use and provide them with clinically approved CAMs where possible. Notwithstanding that CAM use is fairly predictable by socio-demographic variables, further studies should be directed to know the variables useful for predicting the use of each CAM approach.

Complement Ther Clin Pract. 2011 Nov;17(4):199-205. Shorofi SA. School of Nursing & Midwifery, Flinders University, GPO Box 2100, Adelaide 5001, Australia.

by Tim Brunson, PhD

In 1953, in what is probably the most famous cartoon quotation, Pogo stated that "We have met the enemy and he is us." No other utterance so closely conveys my misgivings and concerns about the struggle between the clinical approach to hypnotherapy and the rather idealistic one, which is too much en vogue in contemporary practices. My initial training and the numerous certifications previously received from four well-established international hypnotherapy associations clearly stated that I possessed clinical credentials. Yet upon further reflection and after being challenged in 2006 by a group of medical doctors to reconcile my accomplishments with relevant scientific literature, I started questioning how my colleagues – and even those in the medical and psychology professions – were using the word clinical in regards to hypnotherapy. This pondering continued during my successful efforts to complete a PhD dissertation on neurology and hypnosis. During that process I was expected to clarify, validate, and cite my various statements and claims. Many of my concerns emanate from those efforts.

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Hypnotherapy has many uses in pediatrics, and its value, not only as a adjunct but also as a primary therapy for certain conditions, justifies its inclusion in pediatric training programs. Suggestion and expectation have long been related to therapeutic outcomes in medicine, but not all physicians know how to apply them constructively and systematically in communication with patients. In pediatrics there is a tendency to overlook opportunities in which hypnosis might be the treatment of choice. Because children engage in imagination and fantasy easily without the cognitive inhibitions of adults, they are able to use hypnosis more readily than adults. More research into the imaginative skills of children may facilitate understanding of learning mechanisms and make it possible for professionals to prevent the loss of the natural imaginative capacities in children and, therefore, enhance the ability of mature members of society to use these skills. In addition to reduction of specific symptoms through hypnotherapy, children benefit by the sense of mastery which they acquire, a sense which is surely needed to overcome the feelings of hopelessness, loss of control, and depression induced by many diagnostic and therapeutic procedures in medicine.

Pediatrics. 1978 Aug;62(2):228-33. Olness K, Gardner GG.

Full title: Treatment of HPV with Hypnosis-Psychodynamic Considerations of Psychoneuroimmunology: A Brief Communication.

Abstract There is increasing evidence that the hypnotic cure of warts (infection by the human papilloma virus or HPV) results from activation of an immune response, but whether this is cellular or systemic is unknown. The hypnosis can be by direct suggestion or analytical hypnotherapy when indicated. The evidence is reviewed, and 4 clinical cases suggesting cellular immune response are presented.

Psychoneuroimmunology: A Brief Communication. Int J Clin Exp Hypn. 2011 Oct-Dec;59(4):392-8. Ewin DM. a Tulane University Medical School , New Orleans , Louisiana , USA.

Resting state fMRI (functional magnetic resonance imaging) acquisitions are characterized by low-frequency spontaneous activity in a default mode network (encompassing medial brain areas and linked to self-related processes) and an anticorrelated "extrinsic" system (encompassing lateral frontoparietal areas and modulated via external sensory stimulation). In order to better determine the functional contribution of these networks to conscious awareness, we here sought to transiently modulate their relationship by means of hypnosis. We used independent component analysis (ICA) on resting state fMRI acquisitions during normal wakefulness, under hypnotic state, and during a control condition of autobiographical mental imagery. As compared to mental imagery, hypnosis-induced modulation of resting state fMRI networks resulted in a reduced "extrinsic" lateral frontoparietal cortical connectivity, possibly reflecting a decreased sensory awareness. The default mode network showed an increased connectivity in bilateral angular and middle frontal gyri, whereas its posterior midline and parahippocampal structures decreased their connectivity during hypnosis, supposedly related to an altered "self" awareness and posthypnotic amnesia. In our view, fMRI resting state studies of physiological (e.g., sleep or hypnosis), pharmacological (e.g., sedation or anesthesia), and pathological modulation (e.g., coma or related states) of "intrinsic" default mode and anticorrelated "extrinsic" sensory networks, and their interaction with other cerebral networks, will further improve our understanding of the neural correlates of subjective awareness.

Prog Brain Res. 2011;193:309-22. Demertzi A, Soddu A, Faymonville ME, Bahri MA, Gosseries O, Vanhaudenhuyse A, Phillips C, Maquet P, Noirhomme Q, Luxen A, Laureys S. Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium.

Full Title: Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais.

Of the multitude of treatment options for the management of neck pain, no obvious single treatment modality has been shown to be most efficacious. As such, the clinician should consider alternative treatment modalities if a modality is engaging, available, financially feasible, potentially efficacious, and is low risk for the patient. As evidence-based medicine for neck pain develops, the clinician is faced with the challenge of which treatments to encourage patients to pursue. Treatment modalities explored in this article, including chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais, represent reasonable complementary and alternative medicine methods for patients with neck pain.

Phys Med Rehabil Clin N Am. 2011 Aug;22(3):521-37, ix. Plastaras CT, Schran S, Kim N, Sorosky S, Darr D, Chen MS, Lansky R. Department of Physical Medicine and Rehabilitation, Penn Spine Center, University of Pennsylvania, Philadelphia, PA 19104, USA. Christopher.plastaras@uphs.upenn.edu

Full Title: Top-down and bottom-up mechanisms in mind-body medicine: development of an integrative framework for psychophysiological research.

It has become increasingly evident that bidirectional ("top-down and bottom-up") interactions between the brain and peripheral tissues, including the cardiovascular and immune systems, contribute to both mental and physical health. Therapies directed toward addressing functional links between mind/brain and body may be particularly effective in treating the range of symptoms associated with many chronic diseases. In this paper, we describe the basic components of an integrative psychophysiological framework for research aimed at elucidating the underlying substrates of mind-body therapies. This framework recognizes the multiple levels of the neuraxis at which mind-body interactions occur. We emphasize the role of specific fronto-temporal cortical regions in the representation and control of adverse symptoms, which interact reciprocally with subcortical structures involved in bodily homeostasis and responses to stress. Bidirectional autonomic and neuroendocrine pathways transmit information between the central nervous system and the periphery and facilitate the expression of affective, autonomic, hormonal, and immune responses. We propose that heart rate variability (HRV) and markers of inflammation are important currently available indices of central-peripheral integration and homeostasis within this homeostatic network. Finally, we review current neuroimaging and psychophysiological research from diverse areas of mind-body medicine that supports the framework as a basis for future research on the specific biobehavioral mechanisms of mind-body therapies.

Explore (NY). 2010 Jan;6(1):29-41. Taylor AG, Goehler LE, Galper DI, Innes KE, Bourguignon C. Center for the Study of Complementary and Alternative Therapies, School of Nursing, University of Virginia, Charlottesville, VA, USA. agt@virginia.edu

Physicians have long used the power of suggestion informally in their practice as a means of motivating patients and boosting compliance. Recent research shows that formal use of hypnosis can be a valuable primary or adjunctive therapy, especially in children. Children are more in touch with innate imagery processes than adults and consequently can learn and use self-hypnosis easily, particularly to control autonomic responses. Hypnotherapy has proven useful in habit and behavior disorders, psychophysiologic disorders, pain control, anxiety control, cellular growth, and chronic conditions. The cases reported here illustrate the effectiveness of this process in children. Before hypnotherapy can be used clinically, the physician should become certified by an association approved by the American Medical Association and know when hypnotherapy is indicated and how long it should be continued.

Postgrad Med. 1986 Mar;79(4):95-100, 105. Olness KN.

Full Title: What Factors Are Influencing Preferences Toward Conventional Versus Complementary and Alternative Medical Clinic Advertisements?

Abstract Objectives: The present study aimed to determine whether health service advertisements are perceived differently depending on advertising conventional or complementary and alternative medicine clinics. Methods: A total of 42 adults (male=21, female=21) recruited through advertisements in Seoul, South Korea participated in this study. A standardized health service advertisement was designed with three controlled visual components such as (1) medical treatment information, (2) medical practitioner, and (3) medical facilities and it was shown to subjects while their eye movements were tracked and they were asked to rate their preferences for the different advertisements and their separate components. A multiple regression analysis was performed to see the correlation of the preferences for each of the three visual components with the overall preference rating of each health service advertisement. Results: Preferences for the advertisement depended mostly on the preference for the medical treatment information, whereas advertisements for complementary and alternative medical clinics depended also on the preference for the medical practitioner. Conclusions: These results imply that the same health service advertisement will be perceived differently depending on whether it advertises Western or Oriental medical clinics.

J Altern Complement Med. 2011 Oct 6. Shin HW, Chang DS, Lee H, Kang OS, Lee H, Park HJ, Chae Y. Acupuncture & Meridian Science Research Center, College of Oriental Medicine, Kyung Hee University , Seoul, Republic of Korea .

Hypnotic and nonhypnotic suggestibility were investigated in 2 experiments. In Experiment 1, nonhypnotic suggestibility was suppressed when measured after hypnotic suggestibility, whereas hypnotic suggestibility was not affected by the order of assessment. Experiment 2 confirmed a small but significant effect of hypnosis on suggestibility when nonhypnotic suggestibility was measured first. Nonhypnotic suggestibility was correlated with absorption, fantasy proneness, motivation, and response expectancy, but only expectancy predicted suggestibility when the other variables were controlled. Behavioral response to hypnosis was predicted by nonhypnotic suggestibility, motivation, and expectancy in a model accounting for 53% of the variance. Experiential response to hypnotic suggestion was predicted only by nonhypnotic suggestibility. Unexpectedly, hypnosis was found to decrease suggestibility for a substantial minority of participants.

Braffman W, Kirsch I. Department of Psychology, University of Connecticut, Storrs 06269-1020, USA.

The word "suggestion" has been used in educational, scientific and medical literature in slightly different senses. In psychological medicine the use of suggestion has developed out of the earlier use of hypnotic influence.Charcot defined hypnosis as an artificial hysteria, Bernheim as an artificially increased suggestibility. The two definitions need to be combined to give an adequate account of hypnosis. Moreover, due allowance should be made for the factors of dissociation and of rapport in hypnotic phenomena.The relationships between dissociation, suggestibility, and hypnotizability.Theories of suggestion propounded by Pierre Janet, Freud, McDougall, Pawlow and others. Ernest Jones's theory of the nature of auto-suggestion. Janet explains suggestion in terms of ideo-motor action in which the suggested idea, because of the inactivity of competing ideas, produces its maximum effect. Freud explains rapport in terms of the sex instinct "inhibited in its aim" (transference) and brings in his distinction of "ego" and "ego-ideal" (or "super-ego") to supplement the theory. Jones explains auto-suggestion in terms of narcissism. McDougall explains hypnotic suggestion in terms of the instinct of self-abasement. But different instincts may supply the driving power to produce suggestion-effects in different circumstances. Such instincts as those of self-preservation (fear) and gregariousness may play their part. Auto-suggestion as a therapeutic factor is badly named. It supplements, but does not supplant the will, and makes complete volition possible.

J Pers Soc Psychol. 1999 Sep;77(3):578-87. Brown W. Proc R Soc Med. 1928 Feb;21(4):573-82.

An important area of study has examined cognitive aspects of morningness-eveningness orientation. Optimal times of efficiency in participants classified as Morning and Evening types are of great importance for understanding their cognitive abilities. The present review covers the last two decades (1990-2009), during which the important review by Tankova, Adan, and Buela-Casal appeared, and focuses particularly on attention, memory, and executive functions.

Percept Mot Skills. 2011 Apr;112(2):649-65. Cavallera GM, Boari G, Giudici S, Ortolano A. Dipartimento di Scienze del Movimento Umano, Facoltà di Scienze dell'Educazione Motoria, Università G. D'Annunzio, Chieti-Pescara, Italy. g.cavallera@email.it

As part of a wider argument that history is essential to psychological understanding because of the reflexive nature of psychological knowledge, this article examines the case of mesmerism in early Victorian Britain as an example of how psychological knowledge is both constructive and constructed. It is argued that the shift from "mesmerism" to "hypnotism" was a change in understanding that created a new kind of psychological experience. It is also argued that demonstrations of mesmerism, far from being self-evident facts, could be framed as evidence either for or against the central claims of mesmerism. It is concluded that the case of mesmerism in early Victorian Britain provides a further example of the need for historical understanding within Psychology.

Hist Psychol. 2010 Nov;13(4):393-408. Lamont P. Department of Psychology, University of Edinburgh, United Kingdom. peter.lamont@Ed.ac.uk

by Tim Brunson, PhD

Few concepts garner as much misunderstanding, confusion, and fear as the word hypnosis. Novelists and screenwriters perpetuate these myths as they continually portray hypnotic acts as those done by sinister men who suddenly override the common sense and moral trepidations of unwitting victims. Even respectable professional book publishers regularly contract clinical authors who spice up their work by off-handedly referring to hypnosis or otherwise reinforcing the popular – and scientifically unfounded – clichés that are so popular among psychologists and medical professionals. All the while, they serve more to mislead their colleagues than to enlighten them. Additionally, well-established trade and professional organizations regularly certify their members despite the fact that little – if any – of their educational curriculum reflects the relevant impact of recent scientific revelations.

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Full Title: Between psychology and pedagogy: "moral orthopedics" and case studies of children in fin-de-siècle French medicine.

In the latter decades of the 19th century, European physicians debated a controversial practice that mixed placebos with suggestion therapy to treat children diagnosed with neurotic disorders and behavioral problems. Designed to optimize suggestibility in juvenile patients, this "moral orthopedics" offered parents and therapists the message that children could be saved from becoming victims of their own personalities, of familial neuroses, or even of public health problems. Case studies, published in medical journals and books, circulated accounts of innovative strategies to treat childhood hysteria and to change habits that were considered destructive. Moral orthopedics actualized the insight that suggestibility could be therapeutically productive for juvenile subjects. However, because its adherents sought to manipulate patients' behavior and health by influencing unconscious thought, moral orthopedics provoked questions of expertise and disciplinary propriety among domains of medicine, law, and philosophy. This article reconstructs the controversy surrounding moral orthopedics by examining case studies. I argue that adherents of moral orthopedics did overcome philosophical objections raised against the method, and that they did so through what physician Edgar B6rillon referred to as "education of the will."

Hist Psychol. 2011 Feb;14(1):26-52. Rose AC. Department of History, Grand Valley State University, Allendale, MI 49401, USA. crestienne@gmail.com

PURPOSE: The aims of this study were to evaluate the frequency of complementary and alternative medicine (CAM) use among radiation oncology patients, the coping strategies that influenced this use, and the rates of disclosure of CAM use to their healthcare providers. METHODS: One hundred fifty-three patients undergoing radiation therapy for various neoplasms at rural cancer centers in Minnesota completed the Mayo Complementary and Alternative Medicine Use Survey and the Coping Inventory for Stressful Situations questionnaires. Data regarding CAM use was also compared with provider consultation notes in the medical record at the onset of radiation therapy to determine rates of patient disclosure of CAM use to their healthcare providers. RESULTS: A total of 153 participants completed the study with 61.4% females and 38.6% males and a mean age of 64.9 years. The two most frequent diagnoses of participants were breast cancer (43.8%) and prostate cancer (22.9%). CAM use was reported in 95% of the participants and was categorized into three domains: treatments and techniques, vitamins, and herbs and supplements. The three most frequently reported treatments and techniques were spiritual healing/prayer (62.1%), exercise (19.6%), and music (17.6%). The top three most frequently used biologically based CAM therapies were multivitamins (48.1%), calcium (37.3%), and vitamin with minerals (21.5%). The most frequently used herbs and other dietary supplements were fish oil (19.0%), flaxseed (15.0%), glucosamine (15.0%), and green tea (15.0%). The most common reason cited for CAM treatments and techniques use was previous use (26.1%), for use of vitamins and minerals was recommendation by a physician (33.0%), and for use of herbs and other supplements was previous use (19.0%). One hundred twelve participants reported taking vitamins, minerals, or supplements, and 47% of those 112 did not disclose this use to their providers. CONCLUSIONS: Consistent with previous research, our study found that the majority of cancer patients used CAM treatments. Spiritual healing/prayer was the most commonly reported, followed by multivitamins. Patients reported using CAM primarily due to previous use and physician recommendation. Unfortunately, disclosure of CAM use to healthcare providers was relatively low.

Support Care Cancer. 2011 Apr;19(4):521-9. Epub 2010 Mar 25. Rausch SM, Winegardner F, Kruk KM, Phatak V, Wahner-Roedler DL, Bauer B, Vincent A. Integrative Medicine, H. Lee Moffitt Cancer Center, Tampa, FL, USA. Sarah.rausch@moffitt.org